The Unintended Impact of COVID-19 Associated Non-Pharmaceutical Interventions on Paediatric Hospital Admissions: An Interrupted Time Series Analysis.

Aim: COVID-19 related non-pharmaceutical interventions (NPIs) disrupted global healthcare utilisation, with notable declines in infection related paediatric hospitalisations. We aimed to identify non-infectious paediatric conditions for which the incidence of hospital admissions increased during the introduction and alleviation of NPIs in 2020.

Methods: We examined anonymous hospitalisation data from Perth's sole tertiary paediatric hospital (Jan 2015-Dec 2020), according to pre-defined age groups (0-4 years, 5-9 years, 10-16 years and 0-16). We identified the most frequent non-infectious diagnoses in these age groups over five different NPI periods. We quantified the impact of NPIs on admissions for the most frequent diagnosis groups (perinatal disorders, mental disorders) using interrupted time series (ITS) analysis.

Results: Following implementation of NPIs, admission rates for perinatal disorders amongst 0-4 year-olds increased by 18% (IRR = 1.18 [95% CI: 1.04-1.35]). ITS analysis revealed non-significant changes in admissions for mental disorders in 10-16 year-olds (IRR = 0.91 [95% CI: 0.79-1.06]). The incidence of eating disorders, however, increased significantly following the introduction of NPIs (IRR = 1.60 [95% CI: 1.14-2.25]).

Conclusions: Changes in admissions for perinatal disorders and eating disorders highlight the unintended impact of COVID-19 associated NPIs on paediatric health. Amongst mental disorders more generally, it is possible that admission rates in 2020 may have been greater had COVID-19 associated NPIs not disrupted pre-pandemic trends. These findings aid our understanding of social factors mediating paediatric disease and may improve healthcare delivery in a post-pandemic era.